At-home treatment is a patient's best medicine

When Violet Whoolery took a nasty tumble down her front steps last October and broke her back, her family thought that she might have to abandon her Brooklyn Park home for a health care facility.

But last week, the 79-year-old was in her bed at her home on Cresswell Road, surrounded by old family photos and cards. A nurse cared for her as her two daughters looked on and her great-grandchildren played in another room.

Harbor Hospital Center's Home Health Agency program allowed Mrs. Whoolery's family to keep her at home near them, rather than at a nursing home or a hospital.

"It would virtually be impossible for her to have any semblance of normal life without the home health care program," said her youngest daughter, Roberta Filleaux, 54, who lives on Haile Avenue.

Mrs. Filleaux turned and asked her mother, "Would you rather be here around your family?"

"Oh yeah," Mrs. Whoolery replied.

Mrs. Whoolery, a widow, is diabetic and has had several strokes and heart attacks. Her right leg is paralyzed. The left leg has gangrene, leaving her unable to walk or get up on her own.

The daughters said they learned about the hospital's home health care agency while their mother was in the hospital's extended-care facility for five weeks, undergoing physical therapy, in hopes of walking again. She came home in June.

Her oldest daughter, Nanetta Appetito, 61, lives with her. A longtime family friend who lives next door watches her mother while she is away from home.

Both daughters work full time. They say the hospital's program has allowed them and their mother to carry on their lives as near normal as possible.

The hospital agency began 10 years ago as a one-woman operation serving a handful of patients. There are about 24 health-care workers and 145 patients now.

Most of the patients are over 65, and suffer from complications caused by congestive heart failure, cerebral and pulmonary disease, cancer or diabetes.

Some need only nursing care, while others need therapy and home health aides. Patients are visited daily or just several times a week, said Pat Rehberg, a register nurse and manager of the program. She attributes the increased case load to shorter hospital stays and increased outpatient services.

The program serves patients from Baltimore and Baltimore and Anne Arundel counties, and sometimes Howard County. The program is certified annually by Medicare and is monitored by the Joint Commission for the Accreditation of Health Care Organizations, said Ms. Rehberg.

A nurse works as a liaison with the agency and the hospital to help determine if a patient would be a good candidate for home care.

The big advantage of the program, Ms. Rehberg said, is it takes nurses into patients' homes, where they can see them in their own environment.

"It's a holistic approach as far as nursing is concerned and in the hospital I think that's difficult," said Ms. Rehberg.

On a recent day, Mrs. Whoolery sat in her bed and engaged in a little playful picking at her nurse, Guadalupe Marquez.

"You like to come here. You like to look at my smiling face," said Mrs. Whoolery.

A registered nurse for more than 35 years, and a home health vTC nurse for one year, Ms. Marquez laughed and took her patient's gentle joking in stride as she moved about, tending to Mrs. Whoolery's needs.

The program is good, Ms. Marquez said, because it "keeps the individual in the home and the family intact."

The families of patients can either call the health care agency 24 hours a day for help or page their nurses.

"We can beep her [Ms. Marquez] and she's here in five minutes. She beeps us right back to see what the emergency is or what we think the emergency is and that's reassuring to know that she can be here," said Mrs. Filleaux.